No magic bullet for preventing repeat DUI offenses

NEW HAVEN >> The last DUI charge Ed Avery received, he was riding on a scooter.

“I didn’t have a license, but I thought I could drive a scooter,” Avery said. “Since I didn’t have a license, I got a ticket.”

Avery, 58, and now living at the Roger Sherman House, a transitional halfway house for men discharged from the correctional system in New Haven, had lost his license after a charge of driving under the influence in 2004.

He received his fifth and last DUI charge in August 2010.

That September, Avery was sentenced to jail for four years.

“They gave me two weeks to get ready; I had to pack,” Avery said. “I wanted 30 days but they didn’t give me any leeway.”

With a DUI charge in 2004 and another from March 2010, Avery was not past the 10-year mark, when his prior offenses would have ceased counting against him.

For Avery, drinking and being in the car was what he was used to doing since, as a teenager, he and his friends would drink in the car out on a bridge in Somers.

Avery, who is now receiving services from the VA Connecticut Healthcare System in West Haven, said he also never really thought he had a problem.

“I would go through spurts where I felt like I was drinking too much, and I should slow down,” Avery said.

Avery said he was used to a lifestyle that included alcohol daily.

“My father was in construction. Someone would go get beer after work, but now times have changed and I didn’t” change, he said.

State laws became stricter for drinking and driving, but Avery said he never changed.

Growing up in Somers, Avery said he had little access to public transportation. “You would be at home cooking, having a couple beers, need something from the store, so you would run to the store to go get it,” Avery said.

Once Avery lost his license, he said it became even harder to avoid driving, since he worked seven days a week.

“I probably could have gotten rides to go to the store but I didn’t want to bother anybody,” he said.

Once it starts, it’s hard to stop

Lindsay Oberleitner, associate research scientist at the Yale School of Medicine and associate director of the Forensic Drug Diversion (ForDD) Clinic, said that while reasons for driving drunk vary, many clients report disbelief that they were impaired at the time of their offense, felt they lacked reasoning as a result of intoxication as well as believing they had no other option but to drive (such as an emergency that required transportation or escaping a dangerous situation).

“Clients’ reports of why they repeat drunk driving varies,” Oberleitner said. “Some clients report that they were unaware that they were over the legal limit for drinking this time or did not believe they would be caught.

“Other clients report a picture consistent with symptoms of more serious substance-dependence symptoms,” she said.

Whatever the reasoning, Dr. Robert Plant, chief clinical officer at Wellmore Behavioral Health in Waterbury and Shelton, said the depth and severity of the issue for those who receive multiple DUI offenses lands on the more severe end of addiction.

“Alcoholism and other addictions are chronic issues that don’t go away,” Plant said.

Oberleitner said 25 percent of the clients being treated at ForDD are DUI offenders and 20 percent are repeat offenders.

During treatment, clients have described a wide range of reactions to their first DUI charge.

“For some clients, the event of being arrested for their drinking can serve as the first evidence that they may have a problem with alcohol or other substance use,” Oberleitner said. “For other clients, they may perceive the arrest as an unlucky occurrence or deny their use or driving under the influence is problematic.”

Oberleitner said there is a final group of clients who struggle with a more serious problem of substance dependence and that a DUI offense is just one of many personal, social, occupational and health issues related to their disorder.

These clients typically will have received multiple DUI charges and have difficulty controlling their drinking despite consequences or simply have an inability to stop despite a desire to do so.

“One of the biggest challenges and what I have recognized over the years is addiction really tends to be chronic with a high risk for relapse,” Plant said. “It is rare that a person comes into treatment once, ends their addiction and goes on to a happy, productive life.”

Plant said it is more likely that it will take several episodes of treatment before a client reaches a level of recovery.

“There is no magic bullet,” Plant said. “If you can convince folks of treatment, they will get better.”

Finding good support and positive relationships is crucial to sustaining recovery, according to Plant. Teaching them problem-solving skills, how to get along better with people, how to refuse substances they have been addicted to, how to analyze a situation where they may be at high risk for relapse are important, as are coping skills, in case support they had during treatment goes away.

In Plant’s program, clients are a part of an intensive outpatient program in which they may receive three hours a day of treatment, group therapy, psychiatric resources, medication management, cognitive behavioral therapies or motivational interviewing, depending on needs.

Oberleitner said her program provides similar services, such as evidence-based individual and group treatment, treatment to combat psychiatric or trauma-related symptoms or treatment plans with monitoring. Each client has his or her own plan and services are tailored toward their needs.

Dr. Ismene Petrakis, chief of psychiatry for the VA Connecticut Healthcare System and a professor of psychiatry at the Yale School of Medicine, said that for some clients, court-ordered treatments can be the most effective.

“There are generally two pieces to (recovery),” Plant said. “One is recognizing that this is really causing harm in my life and others cannot deny anymore, while the other piece is whether or not folks have hopefulness.”

Plant said that, even then, people who don’t have hope of recovering may be able to recognize the harm they are doing to themselves and those around them and find some hope that they can get over their addiction.

“Unfortunately, some get so deeply into it (their addiction), they cannot imagine a life without it,” Plant said. “It is frightening almost, like being underwater without oxygen.”

For clients such as this, Plant said caregivers can use a harm-reduction approach where they will recommend to the client that if they struggle to stay abstinent, find the situation that will cause the least amount of harm to those around them.

“If you get rough with your children when you drink, which some people do, don’t drink around your children,” Plant said.

“Certainly the best thing you can do with addiction is stay abstinent but, short of that, you can give them 10 things they can do to lessen people getting hurt,” he said.

Finding a way to move forward

Avery said it was hard for him to handle being sentenced to jail, but he understood he needed to change and move somewhere else once he was released where he could have access to public transportation.

While in jail, Avery said he enrolled in college and secured a job in the recreational department at the prison. Avery had the opportunity to be a part of the Department of Correction DUI Home Confinement Program, which allows offenders to take part in a five-week educational course while incarcerated before being released earlier than their sentence dictates for a house-arrest, community-based part of the program. Avery was eligible but did not have a required sponsor.

Avery was still allowed out earlier than his sentence dictated and was released on Sept. 3 after three years in prison. He was sent to a 42-day inpatient program, the Brooklyn/Bridge Program in Brooklyn, Conn., where he went to five sessions a day to combat substance-abuse issues. He met with two different clinicians each day, attended a meditation session as well as Alcoholics Anonymous and Narcotics Anonymous meetings.

Now living at the Roger Sherman House, Avery (who served in the Marines from 1974-78) said he is attending meetings for substance abuse through the VA in West Haven and is enrolling in classes again. Avery said he would like to be able to get down to Florida to take care of his mother.

“I am going to stay living near a bus line or get a ride,” Avery said. “You don’t want to go through what I went through. Most people don’t listen, but find a ride if you can.”